Crisdental Grants Pass LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8594 Issued in OR

Legal business name

CRISDENTAL GRANTS PASS LLC

Practice address

934 NE 8TH St
Grants Pass, OR 97526-1641

Phone

(541) 492-1687

Fax

(866) 216-6527

NPI assigned

Aug 9, 2016

Organization subpart

Yes

Parent organization

CRISDENTAL GROUP PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael J Bratland, DMD

Title

Owner

Phone

(541) 492-1687

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1790239697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1405",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700338",
            "telephone_number": "541-492-1687",
            "fax_number": "866-216-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 NE 8TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261641",
            "telephone_number": "541-492-1687",
            "fax_number": "866-216-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISDENTAL GRANTS PASS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISDENTAL GROUP PC",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "BRATLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-492-1687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadie Crane, COTA/L
• Augustina Crees-Roosen
• Krystina Larae Crimi, OTR/L
• Andrea Cripps
• Alex Crisci
• Traci L Crockett-Tully, CPC, CCS
• Stick Crosby
• Gregory Adams Cross
• Savahanna Kay Cruthirds
• David Cuevas Jr.

• General Practice Dentistry in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.